[Plasma substance P assay and the clinical significance].
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Amylases↗
Biomedical subjects
H Tamai
Publications and source records attributed to H Tamai.
The clinical efficacy of a 5-HT1A agonist, SM-3997, in the treatment of bulimia.
Psychotherapeutic and pharmacological treatment of bulimia and vomiting require long duration and frequently entail considerable obstacles in patience compliance, making such regimens difficult to pursue. The regulating mechanism of the appetite center is recognized to be complex and recently an important role of serotonin (5-HT), a neurotransmitter, has been shown in rats. In the present study a newly developed 5-HT1A agonist, SM-3997, was administered to 12 patients with bulimia and its clinical efficacy was evaluated. The patients were treated on an open basis with SM-3997, 30-40 mg/day, for 6-15 weeks. Bulimic behavior stopped completely in 4 patients, was improved in 4 others and was unchanged in the remaining 4. These results suggest that the administration of a 5-HT1A agonist, SM-3997, may be effective in the treatment of bulimia and vomiting and that further investigation is warranted.
Administration, Oral↗
Peripheral blood T lymphocyte sensitization to thyroid microsomal antigen from patients with Graves' disease negative for circulating anti-thyroid microsomal antibodies.
We have studied thyrocyte HLA-DR expression induced by supernatants of peripheral blood mononuclear cells (PBMC) stimulated by thyroid microsomal antigen (TMA), as an index of sensitization of the T lymphocyte in autoimmune thyroid diseases; we have studied PBMC from 11 normal control persons and 19 patients with Graves' disease (GD) in whom serum anti-thyroid microsomal antibodies (AMA) were either not detectable (9 patients) or were positive (10 patients). Thyrocyte HLA-DR induction in response to TMA-treated PBMC supernatants from GD was significantly different from that of normal controls (p less than 0.05, ANOVA). TMA-stimulated GD PBMC supernatants increased thyrocyte HLA-DR index [TMA 1 ng/ml, SI 143 +/- 82 (mean +/- SD), p less than 0.05], but normal PBMC supernatants did not. However there was no significant difference in response in terms of the thyrocyte HLA-DR expression induced by TMA-stimulated PBMC supernatants between AMA seronegative vs seropositive GD. These results suggest the possibility of some dissociation of the activities of T lymphocytes and B lymphocytes in patients with GD in response to thyroid microsomal antigen with or without anti-thyroid microsomal antibodies.
Adult↗
[Coronary arterial rupture during percutaneous transluminal coronary angioplasty: a case report].
A case who developed rupture in a diagonal branch of the left anterior descending coronary artery (LAD) during percutaneous transluminal coronary angioplasty (PTCA) is reported here. The present case was 80-year-old man with severe focal stenosis of the LAD at its junction with a diagonal branch. PTCA for the LAD lesion was successfully performed, but occlusion of the diagonal branch developed later. A subsequent ECG showed elevation of an ST segment in a VL, and PTCA for the diagonal branch was attempted. A 018 Hi-torque floppy guide wire was introduced into the occluded diagonal branch, and its dilatation was attempted using a 2 mm Simpson-Robert catheter. During a maximal pressure of 120 psi, a deformity was found at the distal end of the balloon. Post-PTCA angiograms showed rupture of the diagonal arterial branch, and mild to moderate pericardial effusion was observed by echocardiography. The patient experienced transient hypotension (60 mmHg at systolic), but his condition gradually stabilized after the administration of only a pressor medication. Neither pericardiocentesis nor emergency surgery was performed. The next day, follow-up angiograms showed diagonal branch occlusion at the proximal portion of the rupture site. His clinical course was satisfactory with spontaneous resolution of pericardial effusion and mild elevation of his cardiac enzymes (CPK = 243IU). In this case, it was concluded that the cause of coronary arterial rupture was the difference in diameters of the coronary artery (1 mm) and the balloon catheter (2 mm). This was the first rupture case experienced among 750 PTCA sites (0.13%).(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
[Harlequin syndrome (unilateral flushing and sweating attack) due to a spinal invasion of the left apical lung cancer].
A 54-year-old man was admitted to our hospital because of a persistent pain of the left cervix and scapular region of three-month duration and an abnormal shadow in the chest roentgenograms. Neurological examinations, chest roentgenograms, chest CT scanning, vertebral tomograms and myelogram revealed Pancoast's syndrome concomitant with Horner's syndrome. Four months later, the patient complained of a sudden onset of unilateral flushing and sweating appearing on the right face, cervix and upper chest. Eye drop tests with cocaine, epinephrine and tyramine indicated the lesion of ciliospinal centers between the 8th cervical and 2nd thoracic spines. The unilateral flushing and sweating attack appearing on the intact side without Horner's syndrome seemed to be an excessive response by an intact sympathetic pathway, the other side failing to respond because of a sympathetic deficit.
Flushing↗
Possible disorder of B-cell-related surveillance and malignant lymphoma of the thyroid.
Malignant lymphoma of the thyroid has been shown to be of B-cell origin. To clarify its genetic origin, we have investigated HLA-A, B, C, and DR antigens, and the immunoglobulin G (IgG) heavy-chain allotype, Gm, in such patients. There was no correlation between the occurrence of malignant lymphoma of the thyroid and the HLA antigens tested, but patients with this lymphoma had significantly lower frequency of the Gm1,21 haplotype than healthy persons. These results suggested a disorder of surveillance related to B-cells may be involved in the pathogenesis of malignant lymphoma of the thyroid.
Adult↗
Observation of direct electron heating by the fast waves in the lower-hybrid range of frequencies in the JFT-2M tokamak.
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Journal Article↗
H mode observed in the JFT-2M tokamak with edge heating by electron cyclotron waves.
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Journal Article↗
Changes in membrane constituents and chemiluminescence in vitamin E-deficient red blood cells induced by the xanthine oxidase reaction.
The oxidation of vitamin E-deficient rat red blood cells (RBCs) induced by the hypoxanthine-xanthine oxidase (HX-XOD) system has been performed in an aqueous suspension. The generation of chemiluminescence and the accumulation of thiobarbituric acid-reactive substances (TBARS) were observed initially and were followed by hemolysis. Interestingly, the total counts of chemiluminescence were closely related to the amount of TBARS. The predominant change of membrane proteins induced by the reaction was the depletion of spectrin bands in gel electrophoresis. When RBC ghosts were oxidized with HX-XOD, the sulfhydryl (SH) groups of membrane proteins decreased at an early stage of the incubation, which was coincident with the above protein alteration. Membrane alpha-tocopherol suppressed not only the formation of TBARS but also chemiluminescence and hemolysis; nevertheless, it did not inhibit the protein damage and the loss of SH groups. Moreover, it was concluded that the chemiluminescence observed during the oxidation of RBC membranes was associated mainly with the peroxidation of lipids and only to a minor extent with the oxidation of proteins.
Animals↗
Decreased thyroidal triiodothyronine secretion in patients with anorexia nervosa: influence of weight recovery.
Basal thyroxin (T4), triiodothyronine (T3), and thyrotropin (TSH) concentrations were significantly lower before weight recovery in 10 patients with anorexia nervosa (AN) than they were in control subjects. After weight recovery, basal T4 and TSH levels were unchanged and significantly lower in AN patients than in control subjects. Basal T3 concentrations increased significantly after weight gain: however, concentrations remained lower than those in the control subjects. The maximum increase in T3 and T3 net secretory response to thyrotropin-releasing hormone (TRH), obtained before and after weight recovery, appeared significantly lower than that in control subjects: however, the increases in TSH responses were not different from those of control subjects. Thus, low T3 concentrations in AN patients may be due not only to impaired peripheral conversion of T4 to T3 associated with the altered nutritional state, but also to decreased thyroidal T3 secretion in response to endogenous TSH, which is indicative of hypothalamic-pituitary-thyroidal dysfunction.
Adolescent↗
Stimulation of cyclic AMP production in FRTL-5 thyroid cells by crude immunoglobulin fractions of serum from pregnant women.
In an assay for thyroid-stimulating antibodies, in which FRTL-5 thyroid cells were incubated with crude immunoglobulin (Ig) fractions precipitated from serum with 15% polyethylene glycol, significant increase in cAMP production was elicited by the samples from 25 (35.7%) out of 70 pregnant women. The highest value was 529.5%. There was a close correlation between thyroid stimulating activities and serum hCG concentrations (r = 0.708, P less than 0.001). When 125I-hCG was added to serum from pregnant women, about 20% of the radioactivity was incorporated into the Ig fractions. hCG preparations within a range of concentrations of 30-300 IU/m elicited 2.3-16.5 times increase in cAMP in a dose-dependent manner. Nine pregnant women with serum TSH concentrations less than the lower limit of the normal range (less than 0.25 mU/l) displayed significantly higher values for both thyroid stimulating activities and serum hCG concentrations (P less than 0.001, respectively) compared with those who had normal TSH levels in serum. These data suggest that hCG or its variant may stimulate the thyroid sufficiently to suppress secretion of TSH from the pituitary in some pregnant women.
Adult↗
Methimazole-induced agranulocytosis in Japanese patients with Graves' disease.
We reviewed the records of approximately 7000 Japanese patients whose hyperthyroidism was treated with methimazole (MMI) alone. Four patients (Group I) developed agranulocytosis during a second course of MMI therapy and eight patients (Group II) during an initial course. Six patients (three in each group) received less than 30 mg MMI daily. Agranulocytosis occurred after more than 2 months of therapy (12 weeks-1 year) in five patients. Seven patients were less than 40 years of age. One patient displayed a gradual protracted development of agranulocytosis. These results indicate that agranulocytosis after MMI may occur irrespective of dose, age, duration of treatment, and with a second exposure.
Adult↗
Automated exchange transfusion and exchange rate.
An automated blood exchange transfusion (BET) with a two-site technique has been devised by Goldmann et al and by us, using an infusion pump. With this method, we successfully performed exchange transfusions 189 times in the past four years on 110 infants with birth weights ranging from 530 g to 4,000 g. The exchange rate by the automated method was compared with the rate by Diamond's method. Serum bilirubin (SB) levels before and after BET and the maximal SB rebound within 24 hours after BET were: 21.6 +/- 2.4, 11.5 +/- 2.2, and 15.0 +/- 1.5 mg/dl in the automated method, and 22.0 +/- 2.9, 11.2 +/- 2.5, and 17.7 +/- 3.2 mg/dl in Diamond's method, respectively. The result showed that the maximal rebound of the SB level within 24 hours after BET was significantly lower in the automated method than in Diamond's method (p less than 0.01), though SB levels before and after BET were not significantly different between the two methods. The exchange rate was also measured by means of staining the fetal red cells (F cells) both in the automated method and in Diamond's method, and comparing them. The exchange rate of F cells in Diamond's method went down along the theoretical exchange curve proposed by Diamond, while the rate in the automated method was significantly better than in Diamond's, especially in the early stage of BET (p less than 0.01). We believe that the use of this automated method may give better results than Diamond's method in the rate of exchange, because this method is performed with a two-site technique using a peripheral artery and vein.
Bilirubin↗
The significance of antithyroglobulin and antithyroidal microsomal antibodies in patients with hyperthyroidism due to Graves' disease treated with antithyroidal drugs.
The presence of serum antithyroglobulin (TGHA) and antithyroidal microsomal (MCHA) antibodies in Graves' disease patients is associated with lymphocytic infiltration of the thyroid. The aim of this study was to determine the clinical significance of TGHA and MCHA during and after treatment of hyperthyroidism due to Graves' disease. One hundred and seventeen such patients were treated for 2 yr with methimazole and then followed for an additional year or more (mean, 30 months). The patients were classified into the following three groups: group I, patients negative for TGHA and MCHA before and during the 2 yr of treatment; group II, patients positive for MCHA but negative for TGHA before and during the 2 yr of treatment; and group III, patients who were positive for both TGHA and MCHA before and during treatment. The relapse rates after discontinuation of treatment in these groups were 39% (13 of 33), 27% (13 of 48), and 11% (4 of 36), respectively; the value in group I was significantly higher than that in group III (P less than 0.01). The results suggest that the presence of TGHA and MCHA may influence the prognosis of Graves' disease in patients treated with methimazole. Those patients who had neither antibody before and during treatment were most likely to have a relapse of hyperthyroidism, and those who had both antibodies were least likely to have a relapse.
Adolescent↗
Role of thyrotropin receptor antibodies in the development of hyperthyroidism: follow-up studies on nine patients with Graves' disease.
TSH binding inhibitor immunoglobulin (TBII) and thyroid-stimulating antibody (TSAb) activities were measured serially for 4-32 months in nine patients before and during development of hyperthyroidism due to Graves' disease. Initially, all were euthyroid, seven had thyroid enlargement, one had proptosis, and seven had high serum titers of antithyroid microsomal antibodies. The occurrence of hyperthyroidism was preceded by detection of both TBII and TSAb in four patients and detection of TSAb alone in four patients. One patient had neither TBII nor TSAb when euthyroid. The mean initial TBII and TSAb activities were 10.2 +/- 15.2% (+/- SD) and 2677 +/- 4620%, respectively, when these patients were euthyroid. When they became hyperthyroid, both TBII and TSAb activities increased in all patients. At that time, TBII was detected in all but one (eight of nine subjects; 88.9%), with a mean activity of 58.8 +/- 23.4% (+/- SD), and TSAb was detected in all nine patients, with a mean value of 4508 +/- 4429%. These findings not only indicate the crucial role of TSH receptor antibodies in the development of hyperthyroidism due to Graves' disease, but also suggest that a certain period of subclinical Graves' disease exists before the onset of overt hyperthyroidism in most patients, in the sense that they have TSH receptor antibodies, especially TSAb, in their serum even though they are euthyroid.
Adult↗
Development of spontaneous hypothyroidism in patients with Graves' disease treated with antithyroidal drugs: clinical, immunological, and histological findings in 26 patients.
Graves' disease may result eventually in hypothyroidism in approximately 5-20% of patients. In a few such patients hypothyroidism was associated with TSH-blocking antibodies, but whether the frequency of TSH-blocking antibodies in such patients is as high as it is (21%) in patients with primary myxedema is not known. This study was undertaken to determine the presence of various immunoglobulins [TSH binding inhibitor immunoglobulins, thyroid-stimulating antibodies (TSAb), and TSH-blocking antibodies] in 26 patients with Graves' disease who developed hypothyroidism from 0.5-10 yr or more after discontinuation of antithyroid drug therapy. Eight of the 26 patients (31%) had TSH-blocking antibodies, 16 (61%) had TSAb, and 14 (54%) had thyroid hormone binding inhibitor immunoglobulins. Thyroid needle biopsies were performed in 9 patients. Three of 5 patients who had subclinical hypothyroidism had chronic lymphocytic thyroiditis, and all had positive TSAb titers. Three patients had the fibrous variant of chronic lymphocytic thyroiditis; their TSAb values were 902%, 431%, and 1290%. One patient had follicular hyperplasia. We conclude that TSH-blocking antibodies may account for hypothyroidism in approximately one third of patients with Graves' disease who were previously treated with antithyroid drugs, and that autoimmune thyroiditis is comparable for the hypothyroidism in the remaining two thirds of Graves' disease patients.
Adolescent↗
Changes in serum thyroid hormone, thyrotropin and thyroglobulin concentrations during thyroxine therapy in patients with solitary thyroid nodules.
We studied the effect of therapy with 0.1 mg/day T4 for 3 months on goiter size in 49 patients with solitary thyroid nodules. The nodule volume in 18 patients (responders) decreased by more than 50%. In this group the mean serum thyroglobulin (Tg) levels decreased significantly (from 425 to 61 micrograms/L; P less than 0.01). In the nonresponders the mean serum Tg levels did not change significantly (145 vs. 250 micrograms/L). The mean serum T4, free T4, free T3, and rT3 concentrations increased significantly in both groups during T4 therapy, serum T3 levels did not change, and serum TSH decreased. These findings demonstrate that serum Tg levels decrease when T4 therapy is effective. Thus, serum Tg measurements may prove a useful indicator of the efficacy of T4 therapy in patients with solitary nodules.
Adolescent↗
Hashimoto's thyroiditis and HLA in Japanese.
To investigate genetic factors involved in the pathogenesis of Hashimoto's thyroiditis (HT; goitrous autoimmune thyroiditis), HLA class I and class II antigens were analyzed in both seropositive HT (99 patients) and seronegative HT (43 patients). The frequency of HLA-DRw53 antigen was increased significantly in both seropositive HT (antigen frequency, 0.83; relative risk, 33.3; P less than 0.0002; corrected P less than 0.001) and seronegative HT (antigen frequency, 0.81; relative risk, 3.02; P less than 0.01; corrected P less than 0.05). The etiological fraction values for HLA-DRw53 in seropositive HT and seronegative HT were 0.58 and 0.54, respectively. An increased frequency of HLA-DQw4 and a decreased frequency of HLA-DQw1 were observed in patients with seronegative HT. These data suggest that susceptibility to HT is primarily associated with HLA-DRw53 and that HLA-DQ alleles may control the production of autoantibodies to the thyroid gland. The mode of inheritance of disease susceptibility for HT (controlled by a major gene in linkage disequilibrium with HLA-DRw53) was investigated by the method of Thomson and Bodmer, and it was suggested that disease susceptibility was inherited in a dominant manner.
Female↗